Mission
Marimed Foundation for Island Health Care Training was established in 1984 as a Hawai`i nonprofit organization to provide primary health care services and training to remote island communities in the former United States Trust Territories of the Pacific. In the 1990s, Marimed revised its mission to focus on behavioral health care services for adolescents and their families in Hawaii. However, the Foundation continues to support special health care training missions to other island communities in times of crisis.
Micronesia
Marimed began with the vision of the founders, David Higgins, a Harvard educated lawyer and ship captain, and his wife, Dr. Ilona Higgins, a Board Certified Ob/Gyn, to design and build a sailing ship to attract financial resources, medical volunteers, and donated supplies to serve the outer atolls in the Republic of the Marshall Islands, site of the US nuclear testing in the 1950s. The ship would support a system of rural dispensaries on atolls without air strips, carrying volunteer heath professionals on regular “rounds” to train and support local health workers in their home communities.
From 1984 through 1986, Marimed staff and volunteers joined forces with Marshall Island Ministry of Health personnel initiating a series of clinics in the most isolated outer atoll communities. These early clinics established trust and rapport between Marimed staff and their Marshallese counterparts and allowed the gathering of information needed to refine both program and vessel design.
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The Tole Mour (“gift of life and health”), a 156-foot top-sail schooner, was commissioned in Seattle in the fall of 1988. For the following four years, she made regular “medical rounds” in the outer Marshall Islands, serving 15,000 men, women, and children in 58 small communities on a dozen atolls.
In 1990, Marimed launched its Ocean Skills and Education Program for youth from both Hawai`i and the Marshall Islands. During the next two years, these youth accompanied and assisted Tole Mour’s health teams as they made their rounds of the outer Marshall Islands. At the same time, the need for innovative approaches to the challenge of treating and educating Hawai`i youth with behavioral problems was reaching crisis proportions.
In 1992, the primary health care and education programs of the Foundation were turned over to the Marshall Islands Ministry of Health, which had by then built dispensaries and airstrips on the atolls served by the ship. The Tole Mour came “home” to Hawai`i to refocus its energies on Hawai`i and on the youth development and behavioral heath programs initiated in 1990. |
Hawai`i
Since 1993 Marimed has operated the Kailana Program for at-risk youth throughout Hawai`i, in addition to several other youth and adult programs. Information about these programs can be found in other sections of this website.
Around the World
Over the years, Marimed has responded to natural disasters and health problems around the world. Mostly this has been through donations of equipment and supplies, transportation and logistics, or volunteer support in the Pacific.
Haiti
Marimed’s Empowerment Model for Community Development in action through the
Cervical Cancer Prevention, Screening and
Treatment Project in St. Marc, Haiti
A 7.0 magnitude earthquake struck Haiti in January 2010 causing widespread devastation, killing 200,000 people in the Port Au Prince area alone, and leaving over 1 million men, women and children homeless. As the world watched and responded with compassion, first thoughts were on treating the injured and housing the homeless.
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Dr. Ilona (“Lonny”) Higgins, Marimed’s co-founder and Medical Director, understood that in the wake of this terrible destruction and loss of life, the nation’s medical infrastructure would also need attention. She made an initial trip to Haiti in March 2010 as a volunteer with Hospitals for Humanity. While volunteering her medical services, she wanted to learn how the flood of international recovery efforts was going to translate into support for Haitian health care providers as they sought to sustain and improve existing health care delivery systems following the initial response to the overwhelming demands resulting from the earthquake. |
During that trip, Lonny developed a close working relationship with doctors and administrators at St. Nicholas Hospital (“SNH”), a public hospital in St. Marc. She returned from that first learning experience convinced she could assemble and coordinate a small team to respond to long-term needs identified by the SNH staff, following the empowerment model for community development work that Marimed used in the Marshall Islands in the 1980s and 90s.
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St. Nicholas Hospital is in the coastal port town of Saint-Marc in western Haiti in the Artibonite Department, 60 miles north of Port-au-Prince. It was the epicenter of the cholera outbreak in 2010.
In October 2011, Dr. Higgins returned to the hospital in St. Marc with a team of 17 volunteers, including four doctors, a pediatric nurse practitioner, two RNs, and several health educators. For this service
trip Lonny raised nearly $45,000 for medical supplies and for housing for the volunteers while in Haiti. All the volunteers paid their own air fare. |
During the trip, the doctors and staff at SNH asked Lonny and Honolulu pathologist (and long-time Marimed supporter) Dr. Jim Navin to help develop and introduce a cervical cancer prevention, screening, and treatment program for the St. Marc region. That planning work started in late 2010 and is ongoing, as is fundraising for the program.
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In June 2011, Lonny and Dr. Navin went to Nicaragua for a “trainers training” covering screening and treatment techniques appropriate for areas where resources are limited. The training included VIA, a method of visualizing the cervix after application of acetic acid; colposcopy, a method of enhancing visualization; cryotherapy, a treatment using liquid CO2 to freeze pre-cancerous lesions on the cervix; and LEEP, a method of surgically excising more advanced lesions.
In October 2011, Lonny returned to St. Nicholas Hospital with a small team of four volunteers that included Dr. Cornelius (“Skip”) Granai, the Head of the GYN Oncology Department at Brown University, and long-time Marimed friend and supporter, Francis L. (“Peter”) Higginson, Ed.D., former head of UNESCO for the Pacific region.
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Marimed’s focus is on skills training for Haitian health care professionals at public hospitals. |
The team conducted a 10-day training clinic at the hospital aimed at:
▪ developing the hospital’s institutional capacity to screen for and treat pre-cancerous lesions of the cervix and carcinoma in situ of the cervix.
▪ identifying lesions suspicious for invasive cervical cancer,
▪ assessing ongoing training needs, and
▪ establishing weekly cervical cancer screening and treatment clinics at the hospital conducted by the hospital staff.
As a result of that October trip, Skip agreed to host at Brown University selected Haitian doctors trained in VIA, colposcopy, cryo-therapy, and LEEP. He also agreed to return to Haiti periodically with his GYN Oncology fellows or other doctors from Brown for continued on-site training.
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Peter Higginson’s post-October 2011 efforts focused on program planning and evaluation and on the development of cooperative relationships with other NGOs working in Haiti, including Partners in Health in Boston (PIH) and Zanmi La Sante, PIH’s Haitian affiliate.
A huge boost to the program came from Cooper Surgical, Inc., which donated specialized gynecological equipment, which has been transferred to St. Nicholas Hospital. The donation included a colposcope, a LEEP station, two cryotherapy units, four CO2 tanks, and a variety of consumable supplies.
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2012: Here’s the most recent update
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By January of 2012, St. Nicholas Hospital had already initiated weekly cervical cancer screening clinics for the St. Marc community, utilizing the equipment donated by Cooper Surgical.
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In February 2012 a team of seven Marimed volunteers returned to Haiti to complete the next phase of training the Haitian medical staff. Ten Haitian doctors and nurses, some from other regional hospitals and clinics, participated in the training, which was conducted again by Lonny and Skip, this time joined by Dr. Sandra Carson, the head of reproductive endocrinology at Brown University. This training focused on diagnosis and management of more advanced cervical lesions. It consisted of two components, one didactic (theoretical instruction) and the other practical (hands-on), allowing each of the ten trainees the opportunity to perform the procedures on patients during the week-long clinic.
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It is Marimed’s view that a brighter, more enthusiastic group would be hard to find, something that argues well for the future of the individual training participants, as well as the regional hospitals and patients to which they returned at the end of the training.
Marimed believes this is the first cancer screening, treatment and prevention program of its kind to be initiated and entirely run by Haitian health care providers in the lower Artibonite region and serves as a good example of what Haitians can do to raise their standard of health when given the
opportunity to identify their own priorities and the tools to address the needs they have identified.
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By the end of 2012, Saint Nicholas Hospital
expects to have screened and treated more than 1,000 women!
The Future
Weekly Marimed-funded screen-and-treat clinics are now being run at Hospital St. Nicholas by its staff. Later this year, Dr. Skip Granai will be hosting, at Brown University and at Women and Infants Hospital in Providence, some of the Haitian physicians who participated in the February 2012 training.
Follow up training visits to Haiti are in the planning stage. The exact timing for the next training depends on the availability of funds and the trainers’ schedules.
We are very grateful to all of you whose support is making this program possible and who are investing with us in the future of Haitian women and families.
Your help is needed to continue this important work.
Please make your donation today, payable to:
"Marimed Foundation/Haiti Project"
Address: Marimed Foundation
45-021 Likeke Pl.
Kaneohe , HI 96744-2426
Please include your e-mail address
if you’d like to receive a link to periodic photos of project progress.
Questions, comments, donations? Please email Lynn at Lynn.Carey@Marimed.org
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